经皮椎间孔镜技术与传统椎板开窗术式治疗复发性腰椎间盘突出症的疗效对比

发布时间：2018-04-17 11:54

本文选题：经皮椎间孔镜技术 + 传统椎板开窗术　；参考：《中华骨与关节外科杂志》2016年03期

【摘要】：背景:对于复发性腰椎间盘突出症通常要采用手术治疗来达到康复目的。目前主要手术方式包括经皮椎间孔镜技术(percutaneous transforaminal endoscopic discectomy,PTED)与传统椎板开窗术。目的:探讨经皮椎间孔镜技术与传统椎板开窗术式治疗复发性腰椎间盘突出症的临床疗效。方法:选取我院2015年5月至2016年4月收治的骨科住院患者36例作为研究对象,男21例,女15例;年龄18~63岁,平均(46.5±8.9)岁。依据手术方式分为研究组与对照组。研究组采用经皮椎间孔镜技术治疗,对照组采用传统椎板开窗术式治疗。对两组患者术前、术后1周及术后3周腰椎JOA评分及疼痛视觉模拟评分(VAS)进行评估,比较两组手术时间和术中出血量。结果:研究组患者术中出血量显著少于对照组(P0.05)。而对照组患者手术时长相比于研究组更短(P0.05)。手术前后两组腰椎JOA评分比较无显著性差异(P0.05)。组内比较显示,两组患者手术后JOA得分均较手术前增加(P0.05)。从VAS评分看,两组患者术前与术后3周VAS评分表现不存在显著差异(P0.05),然而研究组患者术后1周VAS评分明显低于对照组(P0.05)。研究组患者并发症发生率较对照组低,且未出现严重的并发症。结论:经皮椎间孔镜椎间盘切除术作为传统椎板开窗术基础上改进的微创术,结合了传统手术技术优势,可以准确摘离病变组织,减少手术对患者伤害,良好控制手术出血,并取得可靠治疗效果,值得在临床中推广运用。
[Abstract]:Background: recurrent lumbar disc herniation is usually treated with surgery for rehabilitation.At present, the main surgical methods include percutaneous transforaminal endoscopic discectomy and traditional laminectomy.Objective: to investigate the clinical effect of percutaneous foramen technique and traditional laminectomy in the treatment of recurrent lumbar disc herniation.Methods: from May 2015 to April 2016, 36 orthopaedic inpatients, 21 males and 15 females, aged 1863 years with an average age of 46.5 卤8.9 years, were selected.According to the operation method, the study group and the control group were divided.The study group was treated with percutaneous foramen technique, while the control group was treated with traditional laminar fenestration.The JOA score and visual analogue score of pain were evaluated before, 1 week and 3 weeks after operation in the two groups, and the operative time and intraoperative bleeding volume were compared between the two groups.Results: the amount of intraoperative bleeding in the study group was significantly less than that in the control group (P 0.05).The patients in the control group had shorter appearance at operation than those in the study group (P 0.05).There was no significant difference in JOA score between the two groups before and after operation (P 0.05).Intragroup comparison showed that the JOA scores of the two groups were significantly higher than those before operation (P 0.05).According to the VAS score, there was no significant difference in VAS scores between the two groups before and 3 weeks after operation. However, the VAS score in the study group was significantly lower than that in the control group at 1 week after operation (P 0.05).The incidence of complications in the study group was lower than that in the control group, and there were no serious complications.Conclusion: percutaneous foraminal discectomy is an improved minimally invasive surgery based on the traditional laminectomy, which combines the advantages of the traditional surgical techniques, and can remove the lesion tissue accurately, reduce the injury to the patients, and control the operative bleeding well.It is worth popularizing and applying in clinic because of the reliable therapeutic effect.
【作者单位】：山东省巨野县人民医院骨三科;
【分类号】：R687.3

【参考文献】